Key messages

• Changes in neuronal function produce recognizable electroencephalogram (EEG) patterns, which have been analyzed and classified.

• Progressive reduction of cerebral blood flow is reflected in the EEG and evoked potentials by a sequence of changes which appear before irreversible damage has occurred.

• Fits are clinically unrecognizable in the presence of neuromuscular blockade; therefore if paralysis is used in status epilepticus, EEG monitoring is essential to prevent ischemic neuronal damage due to persistent seizure activity.

• EEG and evoked potential monitoring can affect clinical decision-making in a high proportion of comatose patients.

• In countries where the legal definition of brain death includes an isoelectric EEG, a multichannel EEG should be recorded, conforming to stringent technical standards.

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